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Updated: Aug 2, 2025
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A Large Lateral Craniotomy Procedure for Mesoscale Wide-field Optical Imaging of Brain Activity
Published on: May 7, 2017
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Craniotomy size determines the neurosurgeon - microscope interaction: A proof-of-concept study
D I Pitskhelauri1, N S Grachev1, G V Danilov1
1Department of Neurooncology, Burdenko Neurosurgery Center, 4-ya Tverskaya-Yamskaya 16 St., Moscow 125047, Russian Federation.
Summary
This study found that larger craniotomy sizes in neurosurgery lead to more frequent microscope repositioning and higher magnification use. Minimally invasive burr hole approaches significantly reduce these interactions during surgery.
Area of Science:
- Neurosurgery
- Surgical Technology
- Medical Engineering
Background:
- Minimally invasive surgical techniques are increasingly adopted in neurosurgery.
- Understanding surgeon-microscope interaction is crucial for optimizing surgical workflows and outcomes.
- Quantitative analysis of surgical movements can reveal differences between traditional and novel approaches.
Purpose of the Study:
- To compare quantitative parameters of neurosurgeon-microscope interactions during traditional standard craniotomy (SC) versus minimally invasive burr hole (BH) approaches for intracranial tumors.
- To identify significant differences in microscope usage between the two surgical methods.
Main Methods:
- A prospective observational study involving 18 patients with intracranial tumors.
- Patients were divided into SC (3-4.5 cm aperture) and BH (1.4 cm diameter) groups.
- Three video cameras recorded and analyzed surgeon-microscope interactions, measuring repositioning frequency, magnification time, and focal length changes per minute of surgery.
Main Results:
- Nine parameters showed significant differences (p < 0.05) between SC and BH groups, including total microscope repositioning time, adjustments per minute, duration of adjustments, and time spent at various magnifications.
- Proportions of operating time at high and low magnification, as well as total interaction time, also differed significantly.
- All significant findings remained robust after Benjamini-Hochberg adjustment.
Conclusions:
- A direct and significant relationship exists between craniotomy size and the frequency of microscope repositioning.
- Craniotomy size also correlates with the degree of intraoperative microscope magnification used by neurosurgeons.
- Minimally invasive burr hole techniques appear to reduce surgeon-microscope interaction intensity compared to standard craniotomies.
